Asheville follows national trend of increased heroin use

According to the Center for Disease Control and Prevention, heroin use rose in all demographics in the past decade. However, the average college student is at high risk compared to other age groups. The number of heroin users within the ages of 18 to 25 more than doubled from 2002 to 2013 and are a high-risk demographic.

Almost half of heroin users have an addiction to prescribed opioids used for pain management as well.

“The face of heroin addiction has changed dramatically,” said Barbara Galloway, substance abuse coordinator at UNC Asheville’s Health and Counseling Center. “There’s lots of people using heroin who are very high-functioning.”

Addiction can start innocently enough: an athlete gets injured, a student gets their wisdom teeth removed. Galloway said opiates like hydrocodone, oxycodone and vicodin are often prescribed in these common situations. Most people will not get addicted, but those who experience an especially good high might continue to use after their injury.

“It’s not because they’re bad people or sleazy people,” Galloway said. “It’s just because opiates are horribly addicting.”

The step from opiates to heroin can be a forced one. Pills are very regulated and expensive. Galloway said heroin is comparatively cheap and easy to find. Users often try to avoid withdrawal symptoms by turning to heroin.

The challenge for heroin users is not finding the drugs, but finding a needle. When WNC AIDS Project started their needle exchange in 1994, WNCAP employee Michael Harney said they thought it was impressive to give out 1000 clean needles a year.

Marc Burrows, addiction counselor and recovered addict, is trying to get a similar program started where he lives in Greenville, South Carolina.

Burrows said in his home state of New Jersey a separate needle market formed where people bought a clean needle on the street for five dollars because it is illegal for pharmacies to sell nonprescription syringes.

According to NC Board of Pharmacy, an individual in North Carolina can buy nonprescription syringes from a pharmacy, but a pharmacist can choose not to sell syringes to someone they suspect as a drug user.

“Dirty needles are not a deterrent to using,” Galloway said. “If someone is at the deep end of their addiction, they’re going to use what they’ve got — might as well make it clean and safe.”

Burrows and Harney described the needles they had seen people use in past situations. Users sharpen dull needles with matchbooks or just use the dull needle. Broken plungers, numbers and markings on the barrel completely faded away, yet the quality of the needle will not deter a heroin user.

These dangerous conditions are why WNCAP created the needle exchange. Harney said a reused needle is dangerous. Not just because a user cannot accurately measure how much heroin they are administering to themselves or because the initial injection might be more painful, but because reused shared needles are a way to transmit HIV, viral hepatitis and other bloodborne pathogens.

Harney said needles selling for $5 on the streets of New Jersey can be purchased for about 8 cents.

“Legality and morality, those are secondary issues to the issue of public health. Nobody should have to worry that they’re using a dirty needle or don’t have access to a clean needle,” Harney said. “Insulin, steroids, hormones, drugs, vitamins, I don’t care why you’re using the needle. That you have a need is what’s important to me.”

Harney said the stigma of drug use is why clean syringes can be difficult to acquire.

“‘You use drugs, motherfucker!’ I want to say. You drink coffee in the morning to get you high. You smoke a cigarette if you need that relaxation, whatever. You take an aspirin. You take whatever pill everybody’s taking. Everybody’s using drugs,” Harney said. “I don’t understand at what point you’re not a drug user. We’re a drug-using society. We use drugs for a lot of things.”

However, WNCAP does not promote drug use. WNCAP’s goal is not to stop people from using, it is to protect people who inject from harm.

“I think one of the great things about doing something like this is the point of contact. People who would never walk in the doors of a doctor’s office or a counselor’s, whatever. They’re getting in touch with people like Michael or whoever, and I think that’s where the magic happens,” Burrows said. “You can keep them safe while they’re doing their thing, but when they’re ready to reach out for help, they know where to go. They know who’s going to help them. They know who’s got compassion. They know where there’s tons of literature.”

The window for helping an addict closes quickly. Burrows said if they do not receive help when they are asking for it, months or years may pass before they reach out again.

With the number of heroin-related deaths quadrupling since 2002, according to the CDC, heroin users may not have a few more months or years.

Galloway said heroin requires larger doses for users to experience the same effect, and though users may start out as high-functioning individuals and may maintain that for a while, heroin addiction is not an addiction to be sustained long-term.

Heroin use increased in almost all demographics, college students included, and the reality is many high-achieving as well as struggling students use heroin. Galloway said there is no way to tell who is using.

Because heroin is usually not a recreational drug like alcohol or marijuana, it is not as visible. Galloway said there is a lot of stigma and shame surrounding heroin use, so users usually choose to inject it in private.

UNCA’s Health and Counseling Center focuses on finding solutions and strategies for any heroin user who comes in for help. Galloway said at that point their history does not matter.

“I can’t figure out at what point we lose our humanity,” Harney said. “If I go to the health department to get my flu shot today, I’ll be damned if the nurse is going to dig into her red sharps container here and pull out a needle she used on you, and you, and three other people a flu shot, and tell me ‘I only used it four or five times, it’s ready for you.’ I’m like ‘Oh hell no! You’ll break open a new needle for me.’ So when I leave a healthcare setting, I don’t have access to clean needles? At what point do I lose my humanity?”

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